= Solution
\b[Translation.] Just as this great narrowness of the <blood vessels>, particularly in a body of this kind, had perhaps been the beginning of all the <diseases>, so I do not doubt that the hardness of the <pancreas>, and still more that of the <duodenum>, was the cause of the <vomiting>. For whether that portion of the <intestine> is constricted by compression, as <Riolan> long ago observed, whom you will see cited here in the <Sepulchretum by Théophile Bonet>, or whether, because its coats are <scirrhous>, it is quite unable to contract, these opposite causes are followed by the same effect: since the contents about to descend from the <stomach> are either less readily received or less readily propelled onwards, most of them remain in the <stomach>, and there, either becoming corrupted or simply troublesome and oppressive through their delay, provoke <vomiting>. The distinguished <Molinelli> has also published a clear example of this. The same thing must happen when the <pylorus> is affected by defects of the same kind.
You have very many examples here in the <Sepulchretum by Théophile Bonet>, as in Observations XI and XVII and most of the others following almost as far as XXVI, and again in LVI, §13; in the Additions, in Observations I and VIII; and indeed elsewhere, as in Book I, Section IX, not only in Observation XXXIV but also, if you attend to those “upturnings”, in XXXIII. Among those which you will read in this Section VIII, when you come to Observation XXI, not very unlike another supplied by <Johannes Bohn>, and find there that <vomiting> of all <food> and finally death within ten days followed blockage of the <pylorus> by a small silver coin which had been swallowed, you will undoubtedly recall that much larger silver coin which the skilful surgeon <du Luc> successfully dislodged from that place and indeed out of the body. He did so with other aids, but especially with <mercury (element)>: pressing it onwards by its <gravitational weight> and reducing it by <amalgamation>, as the <chemists> call it, when pains near the <pylorus> had already begun, with an urge to <vomiting>[vomit] (the printed \i[laevi] at this point is unclear).
\b[The central inference is that different impairments of passage can produce the same <vomiting>.] The author is <Giovanni Battista Morgagni>; the extract corresponds to Book III, Letter XXX, article 13 of <The Seats and Causes of Diseases Investigated by Anatomy by Giovanni Battista Morgagni>. The opening \i[haec], “this”, points back to an anatomical case preceding the selected extract. The translation preserves the difference between the tentative claim \i[fortasse], “perhaps”, about the narrow <blood vessels> and the stronger \i[non dubito], “I do not doubt”, about the cause of <vomiting>. It does not convert either level of historical confidence into a present-day demonstrated diagnosis. <Examination papers for the Degree of Bachelor of Medicine by the University of Oxford (1864–1867)>[PDF volume pp. 73–74, complete Latin extract and attribution to Book III]{ref} <The Seats and Causes of Diseases Investigated by Anatomy by Giovanni Battista Morgagni>[Book III, Letter XXX, articles 12–13; 1769 English version, volume II, p. 53 and continuation]{ref}
The two mechanisms are not contradictory observations. Compression can narrow the entrance to the <duodenum>; hard, poorly contracting intestinal coats can fail to propel their contents onwards. Both impede <gastric emptying>, allowing retained material to provoke <vomiting>. This is an early example of connecting <clinical observation> with <pathological anatomy>. Nevertheless, gross hardness, described as \i[scirrhous], does not by itself supply a modern microscopic diagnosis of <scirrhous carcinoma>. The descriptive term <scirrhous hardening> is therefore kept distinct from that modern category. The separate assertion about the <pancreas> likewise cannot identify its precise <disease> from this extract alone.
The <Sepulchretum by Théophile Bonet> is an earlier compilation of anatomical observations. Its cited observation numbers are retained because they are part of the argument's trail of evidence, including the distinction between Section VIII and the additional cross-reference to Book I, Section IX. \i[Subversiones] literally means “upturnings”; in this context the reference concerns disturbances or upheavals of the <stomach>, not a political meaning. \i[Ventriculus] here is the <stomach>, not a cardiac <heart> ventricle. The printed word \i[laevi] near the end is grammatically unclear in its context; the translation gives the secure surrounding sense and does not silently assign it a patient's identity, an anatomical side, or a new causal claim. <The Seats and Causes of Diseases Investigated by Anatomy by Giovanni Battista Morgagni>[Book III, Letter XXX.13, list of Sepulchretum observations and the two silver-coin reports]{ref} <Sepulchretum by Théophile Bonet>[1679 edition catalogue, title and attribution]{ref}
\b[The coin episode reports an attempted mechanical and chemical remedy, not a modern recommended <treatment>.] In the text, <mercury (element)> is supposed both to press the coin onwards through its <gravitational weight> and to reduce it by <amalgamation> with its <silver>. The report does not establish the contribution of each mechanism, the extent of the coin's alteration, or therapeutic safety. Its purported success should not be generalized from a historical anecdote. Modern toxicological information distinguishes the chemical forms of <mercury (element)> and their routes of exposure: swallowed liquid metal is poorly absorbed, whereas vapour is readily absorbed and can cause serious harm. This distinction neither validates the historical intervention nor warrants the false correction that any swallowed metallic <mercury (element)> must immediately produce systemic poisoning. <Mercury and Human Health by Health Canada>[Health Effects of Mercury Exposure, Elemental Mercury: contrasting ingestion with vapour inhalation]{ref}
Modern investigation also separates obstruction from impaired movement. <Endoscopy> uses a flexible instrument with a camera to inspect the upper digestive passage for structural abnormalities; a <gastric emptying scintigraphy> test instead follows a meal containing a small radioactive tracer with an external camera. These examinations illustrate how the proposed impediment to passage can now be tested rather than inferred from <vomiting> alone. They are later developments, not techniques available to the author of this passage. <Diagnosis of Gastroparesis by NIDDK>[Upper GI endoscopy, Imaging tests, and Tests to Measure Stomach Emptying]{ref}
Back to article page
